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Advisor(s)
Abstract(s)
Transplant glomerulopathy is a sign of chronic kidney allograft damage. It has a distinct morphology and is
associated with poor allograft survival. We aimed to assess the prevalence and clinic-pathologic features of
transplant glomerulopathy, as well as determine the functional and histological implications of its severity. We
performed a single-centre retrospective observational study during an eight-year period. Kidney allograft biopsies
were diagnosed and scored according to the Banff classification, coupled with immunofluorescence studies. The
epidemiology, clinical presentation, outcomes (patient and graft survival) and anti-HLA alloantibodies were evaluated.
Transplant glomerulopathy was diagnosed in 60 kidney transplant biopsies performed for clinical reasons
in 49 patients with ABO compatible renal transplant and a negative T-cell complement dependent cytotoxicity
crossmatch at transplantation. The estimated prevalence of transplant glomerulopathy was 7.4% and its cumulative
prevalence increased over time. C4d staining in peritubular capillaries (27.6%) was lower than the frequency
of anti-HLA antibodies (72.5%), the majority against both classes I and II. Transplant glomerulopathy was associated
with both acute (mainly glomerulitis and peritubular capillaritis) and chronic histologic abnormalities. At
diagnosis, 30% had mild, 23.3% moderate and 46.7% severe transplant glomerulopathy. The severity of transplant
glomerulopathy was associated with the severity of interstitial fibrosis. Other histological features, as well
as clinical manifestations and graft survival, were unrelated to transplant glomerulopathy severity.
Description
Keywords
Glomérulos Renais Transplantação de Rim Biópsia Sobrevivência de Enxerto Glomerulonefrite Rejeição de Enxerto
Citation
Port J Nephrol Hypert 2013; 27(3): 209-215